Behavioral Weight Loss Treatment

for Obesity and Pediatric Overweight

Status: Strong Research Support

Description

Behavioral Weight Loss Treatment (BWL) for obesity is a short-term
intervention designed to achieve acute weight reduction as well as
establish new behavioral patterns to increase the likelihood of
sustained maintenance of weight loss. A well-studied version of BWL for
adults is the LEARN (Lifestyle, Exercise, Attitudes, Relationships, and
Nutrition) Program. As the components of its acronym suggest, LEARN
promotes change in multiple domains to synergistically yield weight
loss. An emphasis of LEARN is the benefit of small, lifestyle-oriented
changes (e.g., getting off a bus at an earlier stop and walking the
remainder of the distance to one’s destination) that can cumulatively
achieve a negative energy balance. LEARN encourages reasonable weight
goals and moderation in food choices (no food is completely forbidden).
LEARN consists of 12 lessons, which can be conducted in individual or
group therapy sessions. BWL for children similarly corrects maladaptive
eating and activity patterns and food choices by targeting nutrition,
diet, and exercise, and a reduction in sedentary activities such as
television viewing. In most adaptations of BWL for children, parents are
enlisted to facilitate and support family-level lifestyle changes that
promote healthy weight. The development of better problem solving skills
for children and parents is an additional part of some protocols. For
children, weight loss is frequently less of a goal than weight
maintenance during a period of growth, the net effect of which is a
reduction in BMI-for-age percentile. BWL typically yields modest
short-term weight loss or BMI-for-age percentile reduction in adults and
children, respectively. Children typically maintain their weight loss
following BWL while adults often experience weight regain, consistent
with the data from other weight loss interventions for the adult
population.